Quiet boom —

North Korea reveals explosive HIV outbreak—after claiming to be disease-free

More than 8,300 cases just months after claims of an "AIDS-free zone."

Enlarge/ This undated picture released by North Korea's official Korean Central News Agency (KCNA) on October 18, 2016, shows North Korean leader Kim Jong-Un (C) inspecting the newly built Ryugyong General Ophthalmic Hospital in Pyongyang.

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North Korea is experiencing an explosive outbreak of HIV amid limited access to diagnostic testing and treatments, according to an exclusive report by Science.

Independent researchers and government health officials tell the outlet that the isolated East Asian country confirmed its first HIV case in 1999 and has quietly watched infections balloon to over 8,300 cases in the last few years. The researchers and North Korean officials have submitted a report on the matter to the new medical preprint server medRxiv, which is scheduled to go live on Tuesday, June 25.

The case estimate stands in stark contrast to a celebration in Pyongyang last year on December 1—annual World AIDS Day—in which government officials declared that North Korea is an “AIDS-free zone” and that there is “not a single AIDS patient” in the country.

The truth of the matter came to light after an unusual collaboration formed. In 2013, North Korean health officials reached out to a US NGO called DoDaum for help tracking the infections. DoDaum already worked on health, education, and development programs in North Korea, and it built up a good rapport with officials. Together, the team worked on assessing the extent of disease spread, particularly in rural areas, as well as the factors driving it.

Blood donors and people who inject drugs appear to be the hardest hit by the outbreak. Efforts to halt the spread of infections have been difficult because there are only three labs in the country that use modern tests to screen for HIV infection. Additionally, international sanctions have made it difficult to import drug treatments, which are not produced domestically. DoDaum says it has helped 3,000 patients gain access to treatment.

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.

Moreover, DoDaum co-founder Taehoon Kim expressed concern that the government could criminalize HIV status and detain or deport patients if the situation worsens. Kim Mun Song called this a “realistic concern... But we hopefully will not have to take measures that violate human rights.”

I suspect that they'll strive to keep their "AIDS Free Zone" by eliminating all cases of AIDS in the country. The unfortunate news is that their methods of eliminating all cases has more to do with attacking the patient than attacking the disease.

Are you saying that pretending that a disease doesn't exist is not an effective treatment? Or worse, persecuting people who have it, making them hide their condition and spreading it to unsuspecting people? It's like the opposite of what you want to do when you have a disease outbreak.

I suspect that they'll strive to keep their "AIDS Free Zone" by eliminating all cases of AIDS in the country. The unfortunate news is that their methods of eliminating all cases has more to do with attacking the patient than attacking the disease.

Treatment regimen: One (1) course: Two (2) bullets administered directly to the back of the head. No followup treatment is prescribed.

I suspect that they'll strive to keep their "AIDS Free Zone" by eliminating all cases of AIDS in the country. The unfortunate news is that their methods of eliminating all cases has more to do with attacking the patient than attacking the disease.

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

"Blood donors and people who inject drugs appear to be the hardest hit by the outbreak."

Blood donors? If that's accurate, then the implication is that they're reusing equipment for donations without proper sterilization. Since they're probably still not using disposable sharps, judging from how far behind they are in other areas.

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

He does, but I imagine that while NK government want to keep a nice face to the outside world, what REALLY matters to them is whether this news is propagated inside NK and cause unrest/lack of faith in the populace. Also, I imagine he has a rather valuable skillset that he probably feels gives him some protection from backlash.

Situation would be a lot better and more open if the country was not blockaded and routinely and casually threatened with complete annihilation by the richest, most powerful nuclear-armed nation to ever exist.

Situation would be a lot better and more open if the country was not blockaded and routinely and casually threatened with complete annihilation by the richest, most powerful nuclear-armed nation to ever exist.

NK's problems are a result of doggedly adhering to totalitarian Maoism, not American intervention. We routinely send massive food shipments to avoid mass starvation in the region.

They've had many, many, many chances over the years to open their society and economy to the wealth available from China, America, and Japan, among others. Instead, they choose empty saber-rattling threats and psychotic devotion to creating Airstrip One IRL.

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

I suspect that they'll strive to keep their "AIDS Free Zone" by eliminating all cases of AIDS in the country. The unfortunate news is that their methods of eliminating all cases has more to do with attacking the patient than attacking the disease.

Treatment regimen: One (1) course: Two (2) bullets administered directly to the back of the head. No followup treatment is prescribed.

Given that North Korea's Healthcare System is not the greatest, and knowing of the rates of infection of HIV in some African countries, I can guarantee you that the infection rate is probably a lot higher than 8500. Keep in mind that this is just reported cases. In some African countries that are hit by the HIV crisis, a good number of deaths caused by of AIDS are reported as the opportunistic illnesses that come after.

I suspect that they'll strive to keep their "AIDS Free Zone" by eliminating all cases of AIDS in the country. The unfortunate news is that their methods of eliminating all cases has more to do with attacking the patient than attacking the disease.

Treatment regimen: One (1) course: Two (2) bullets administered directly to the back of the head. No followup treatment is prescribed.

Seems wasteful.

The double dose is to reduce the already very low failure rate even farther.

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

Situation would be a lot better and more open if the country was not blockaded and routinely and casually threatened with complete annihilation by the richest, most powerful nuclear-armed nation to ever exist.

NK's problems are a result of doggedly adhering to totalitarian Maoism, not American intervention. We routinely send massive food shipments to avoid mass starvation in the region.

They've had many, many, many chances over the years to open their society and economy to the wealth available from China, America, and Japan, among others. Instead, they choose empty saber-rattling threats and psychotic devotion to creating Airstrip One IRL.

Better they capitulate and play by the rules dictated by the US only to see their country dismembered, its infrastructure erased and 1,000,000 dead that wouldn't have died otherwise * like Iraq, or be reduced to a warzone ruled over by competing warlords where the capital city has open-air slave markets now like Libya**, formerly the highest quality of life in Africa, I guess????

Oh yeah, dude, there's no middle ground between remaining a starving hellhole and getting bombed for your resources at all. There's NO WAY they could destalinize and allow free flow of capital and goods into the country from neighboring nations to better the lives of their citizens. Permitting free and open elections is just out of the question. I mean, Jesus, how could they get by without forced labor in the gulags to produce goods for the Democratic People's Republic? Who's ever done any of those things successfully on the Korean peninsula?

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

He does, but I imagine that while NK government want to keep a nice face to the outside world, what REALLY matters to them is whether this news is propagated inside NK and cause unrest/lack of faith in the populace. Also, I imagine he has a rather valuable skillset that he probably feels gives him some protection from backlash.

North Korean officials at first wanted to stay mum about the outbreak, but they changed their minds amid the discouraging circumstances. Kim Mun Song, a physician and external affairs director at the North Korean Ministry of Public Health in Pyongyang, explained to Science:

“On the one hand, reporting the existence of these patients may lead to a backlash from the central government, as they are very much afraid of communicable diseases in general. On the other hand, not reporting and not recognizing the existence will perpetuate the issue of not having treatments.”

Is it just me or does it seem like this guy has some balls saying this publicly?

I suspect that they'll strive to keep their "AIDS Free Zone" by eliminating all cases of AIDS in the country. The unfortunate news is that their methods of eliminating all cases has more to do with attacking the patient than attacking the disease.

At the end of the article, when they mentioned deportation, my first though is that it wouldn't be such a bad thing for those people to be sent to a country that has modern medical access.

Unfortunately what worries me isn't that they might try to remove them from the country, but that they might just execute them in the name of "public health". That of course would be absolutely horrific.

Actually, the original poster is 100% correct. Here’s a little logic for you: all persons with AIDS have HIV; all persons with HIV do not necessarily have AIDS; the vast majority of persons treated for HIV will never develop AIDS, will never transfer HIV to other persons who could or could not later develop AIDS (only if they too did not treat their HIV infection).

If the above is true (which it totally is) then the NK gov’t may be right: they may only have HIV+ pts. Or, if they’re not treating any of these individuals, they have no pts.—so either way they are correct.

What they do have for sure (that is known) is a HIV problem that, if left untreated will eventually lead to an HIV epidemic and later an AIDS problem, if they continue to ignore it.

No, not really. Left untreated, HIV is actually one of the deadliest viruses we know about, its just much less spectacular than Ebola.

The vast majority of untreated patients will develop an HIV related disease in 5-10 years

Or, they have numerous patients with AIDS but, with the limited resources available and due to the government flat-out lying, they can’t test for HIV and are instead treating the opportunistic infections that occur when the immune system is compromised.